Looking at effectiveness during everyday activities with osteoarthritis of the hip

Current data from treatment practice highlights why hip braces can be an effective component in non-surgical osteoarthritis treatment. For Dr. med. Benjamin Rebhan, the non-interventional study using the CoxaTrain clearly confirmed once more: the brace makes his patients’ everyday lives easier.

“When using innovative medical devices in particular, we pay very close attention to our patients’ experiences and feedback. That’s why observational studies that systematically record this type of data are very meaningful for our everyday prescription process because of their practical relevance,” Dr. Benjamin Rebhan explains. The Trauma Surgeon and Orthopedist has a practice in Soltau and is one of five physicians who took part in a non-interventional study relating to the effectiveness of the CoxaTrain. Patients primarily with osteoarthritis of the hip, with different degrees of severity, were treated conservatively and provided with a flexible hip brace by their medical retailer. “The use of braces to treat the wrist or knee has already been established. It was therefore interesting for us to take part in a study that documents the effectiveness of a brace for the hip,” says the physician, describing his motivation. The cases from his practice made up around a third of the test subjects that were examined. “I wasn’t just excited by what I could learn in my own practice but also by the insights from colleagues, and the fact that, in the overall assessment, the same results were obtained across several practices.”

Realistic documentation

Before the study began, the participating physicians listed reduced pain, a relieved hip joint, and mobility preservation as the three key treatment objectives. “In the tool box of conservative treatment options, a working brace is another welcome measure,” Dr. Rebhan explains. Investigating which effects are associated with its use, and how positively this measure is accepted, will support treatment decisions.

In addition to the clinical outcome for patients concerning pain reduction, sensation of stability, and mobility, the study also recorded during which situations the brace was worn, what patients thought of the wearing comfort, and to what extent they were able to perform everyday activities. Dr. Rebhan: “I think looking at effectiveness during everyday activities is particularly realistic. Patients visiting our practice have to go grocery shopping, they may have a dog that needs walking – they don’t want to deal with pain during these activities. In addition, the aspects of use and wearing comfort inform the factors that have a key influence on acceptance and therefore how effective it can be.”

Patient cross-section with practical orientation

The systematic data collection took place from June 2022 to November 2023 with a total of 57 patients – 34 women and 23 men – whose hip pain was treated conservatively and who were given the CoxaTrain as an orthopedic aid. For the most part, the diagnosis was osteoarthritis of the hip at different stages. But patients suffering from coxalgia, hip joint impingement, bursitis trochanterica, and labrum lesion were also included in the data collection. Some patients had multiple diagnoses with additional muscular imbalances, sensations of instability and/or hip dysplasia, or osteoarthritis of the hip together with hip joint impingement. The brace was used in conjunction with conservative measures, such as taking analgesics, physiotherapy, rehabilitative exercise, and applications, such as shock wave or infiltration therapy, as well as acupuncture. On average, the monitoring period was 7.6 weeks per patient. Patients wore the brace for an average of 4.6 hours per day.  

“In the tool box of conservative treatment options, a working brace is another welcome measure.“

Dr. Benjamin Rebhan

Significant improvements

“To be honest,” Dr. Rebhan discloses, “I neither thought that the patients would use the product so compliantly nor that the treatment would have such an effect.” The outcome was assessed on a 10-point VAS scale . Perceived pain reduced by 3.1 points on average. This represents a pain alleviation by 47.7%. A positive side effect: almost half the patients who were taking pain medication reported that they were able to reduce their consumption during treatment, thanks to the brace. Patients’ sensation of stability increased during the monitoring period whilst standing (+2.1), walking on firm, level ground (+2.3) and loose ground, (+2.6) as well as when taking the stairs (+2.5). Furthermore, the distance patients were able to walk without feeling pain increased by 61% when wearing the brace. As a result, patients gave their mobility during everyday and leisure activities 4.2 points without the brace, and 7.2 points with the brace. This increase represents an improvement in mobility by 71.4% and therefore a clearly noticeable reduction in restrictions during everyday activities.

When wearing the CoxaTrain, patients were able to perform activities with low as well as increased load more easily. During activities with low load, patients reported 35.3% relief, during everyday activities with increased load, the improvement was 40.9% on average.

All of the patients gave the medical product a positive rating, which accounts for the high level of compliance. About 70% felt that donning of the brace was easy to very easy. 57.9% rated the fit and positioning as good to excellent. In addition, factors that influence wearing comfort, such as breathability, skin-friendliness, or weight, were given the school grade 2.3 to 2.4, with 1 being the best and 6 being the worst. Pleasing: none of the 57 patients reported any undesired side effects caused by the brace.

Another tool for joint preservation

“Patients suffering from osteoarthritis of the hip are our day-to-day business. This makes these results relevant. Braces, such as the CoxaTrain, are now another tool for us that, in addition to physiotherapy and infiltration – whether cortisone, autologous blood, or Hyaluron – can be used and, in combination with them, can contribute to delaying hip surgery for as long as possible,” summarizes Dr. Rebhan. He adds from personal experience: “Providing patients with comprehensive information is key in any case.” Patients need to know that flexible hip braces, such as the CoxaTrain, will exert their full effect only after some time of using them. Cooperation with a good medical retailer is also beneficial. How the product works can additionally be explained and correct donning shown repeatedly if required. Asked about the conclusion of the study, Dr. Rebhan replies: “A hip brace be an effective addition in particular when patients suffering from osteoarthritis of the hip come to us early, so they can remain pain-free and mobile for longer.”

Those interested can download the results of the non-interventional study with the CoxaTrain as a digital whitepaper in PDF format here.

Pictures: private, Bauerfeind AG